Here’s an example of how this “bad luck domino” sequence might evolve:

Betty, a 45-year old bank executive, suffers a surge of pain in her arms and wrists, after typing out a contract in her office in the Research Triangle. She goes to the doctor, who diagnoses her with carpal tunnel syndrome. She begins massage therapy, cortisol injections, and other treatments, but the process fails to relieve her pain. Within several weeks, she is too incapacitated to move, and she must take time off of work.

Betty seeks workers’ compensation benefits, but her employer fights her tooth and nail. The legal battle drags in dozens of parties and several law firms. When all is said and done, Betty’s case of carpal tunnel syndrome drains millions of dollars of productivity from the economy. Meanwhile, the case consumes court time, which can create a backlog, which in turn forces other workers’ comp plaintiffs to wait; the waiting exacerbates their injuries and extends their recuperating time; and so on and so forth. A bad domino effect.

If we could collectively find ways to deal with the “front end” of Helen’s cascade, then everyone involved in the North Carolina workers’ compensation system would win — law firms, insurance companies, businesses, the state, and most importantly, hurt/sick employees.

The big question is: HOW can we reduce the number of serious injuries and keep that number headed south, in perpetuity?

Policymakers obviously want to help and protect hurt workers. However, few people understand the need to think through this goal systematically. We should not simply strive to reduce the number of workers’ hurt in North Carolina. We should build and refine systems to reduce injuries. That’s a subtle but important difference. It’s the difference between striving to win the lottery and striving to build a successful business.

To build a great system to thwart workplace injuries, we must measure results, test strategies, get feedback from honest and diverse perspectives, and iterate. In an ideal world, insurance companies, the state, attorneys, employees, employers, and occupational safety experts would collaborate to try to find efficiencies.

For instance, let’s just say that carpal tunnel syndrome is a big problem — a major cause of workers’ comp claims. And let’s also say that data suggest that CTS cases could be cut by 30%, if employees had to take 5 minute breaks for every 30 minutes worked. Those are all arbitrary, made-up numbers. But let’s assume them for this thought experiment. Now, imagine if we used those numbers to create statewide “anti-carpal tunnel syndrome” workplace policy. And imagine if it worked. Not only would we reduce CTS cases by 30%, but we’d reverse the whole “bad domino effect” we discussed!